Pharmacist here. You're right, the expiry dates are based on the manufacturer's best guess (based on accelerated stability studies) of guaranteed stability up to that date. Tons of meds last way longer than their expiry--for example, the US army stockpiles meds and has checked if stuff like amoxicillin or pain killers were still good 20+ years after expiry, and they still were.

Now, the inhalers MAY lose some potency after expiry (definitely not an on / off thing), and considering you need them to work in an emergency, you better replace them by the expiry date. But in an apocalypse, I'd bet you could survive off of them for 10+ years. I don't know how well the propellant (thing that delivers the med to your lungs) would hold up though.

A notable exception for bad things to use beyond expiry is the epi-pen. It loses potency very quickly and would not be reliable in an emergency.

Edit: People getting mad at me for not including all cases where expired meds are bad. Sorry, didn't know I was doing a full dissertation on the topic, was just focusing on apocalypse emergency meds... Here's a list I agree with.

Tetracycline - since 100's of people mentioned this one; the warnings were based on a case report of 5 patients who developed kidney failure after taking tetracycline. This was on an old formulation of tetracycline no longer used. And there have been no reports since then. But why risk it? Tetracycline is dirt cheap.

Nuvaring (and any combined hormonal contraception (CHC) (eg. estrogen + progesterone)) does increase the risk of a venous thromboembolism which can lead to a pulmonary embolism. However, don't freak out! Let's put it into context of what the risk actually is.

Poor acetaminophen needs some defense here. Yes, it is the number one cause of liver failure in the world. However, it's also the most commonly used drug in the world (other than caffeine).

The risk of liver issues comes with chronic high dosing (IE taking around 4g per day for years), or with acute overdosing (taking more than 4g in a 24 hours period...around 8g is when you can get serious toxicity). Also, chronic alcoholics (or an episode of binge drinking) + acetaminophen is a bad idea.

Interestingly enough, if you have a few drinks and then take acetaminophen after, it is LESS problematic than taking ibuprofen or naproxen. Everyone thinks the opposite. Alcohol wears away the protective lining of your stomach, so if you add an NSAID after drinking, the risk of ulceration goes up. Regular doses of tylenol don't increase risk of liver damage UNLESS you do it all the time (daily) or have pre-existing liver damage or alcoholism.

I don't recommend taking 4g on a daily basis long-term. Around 2g/day is appropriate long-term. Otherwise, taking 4g for say a week in a row presents such a minimal risk for liver damage if you're healthy.

Edit: Also lots of liver issues noted because of many combo products having high amounts of acet in it.

"Many case reports describe severe liver damage, sometimes fatal, in some alcoholics and persistent heavy drinkers who take only moderate doses of "paracetamol". However, other controlled studies have found no association between "alcohol" intake and "paracetamol"-induced hepatotoxicity. There is controversy about the use of "paracetamol" in alcoholics. Some consider standard therapeutic doses can be used, whereas others recommend the dose of "paracetamol" should be reduced, or "paracetamol" avoided. Occasional and light to moderate drinkers do not seem to be at any extra risk. "

About NSAIDs being potentially worse:

"They note that the alternatives, aspirin and NSAIDs, are associated with a greater risk of gastrointestinal adverse effects in alcoholics. The risk for non-alcoholics, moderate drinkers and those who very occasionally drink a lot appears to be low, although some chronic moderate social drinkers might be at risk.

Fortunately, in Canada we've moved ahead with regulating the herbal world. Herbal products now need to get licensed by Health Canada to ensure good manufacturing practice and the ingredients listed are what's actually in the product. If they prove that, they receive a NPN (natural product number) and can be sold in Canada. Currently, products without an NPN can still be sold, but at least some are more authentic now. Says nothing about their effectiveness though.

I'm not the police. It's not my job to determine what someone requesting needles is going to do with them, or find out if they're lying about it. I'd rather have them using clean needles than using something else anyways.

I do get a little kick when they come up to the counter and give me this whole story before I've said anything, though. "Hey man, my diabetic grandma is so sick and my insulin syringes, which I also use for my diabetes, fell in the toilet so I thought I could get more and help her out, she might die soon if I don't, so can I get a box of 21g long tips?"

It's much less weird if they're just like, "Hey can I get some ___ needles?"

"This is the End" had a funny scene about that. Two characters were clinging to a cliff, one lower than the other and he says, "Ok, grab my arm, then swing me to the top!" And they're both like, yeah, yeah we can do this no problem. So as they lock arms he drops the one guy immediately to his death.

If you're not aware, Coda starts at the bottom of the dungeon (hardest zone), dies in one hit, can only ever use the dagger, if you miss a single beat at any time you die, and everything is double speed. Truly impressive!

Edit: NM, I noticed Coda doesn't start on the bottom anymore. Oh, and you die if you pick up any gold (which monsters always leave on death, so you can block yourself off easily

What it is: It is a compilation of over 400 mods that you can pick and choose from. It will then do the process of downloading and installing them for you, which was a huge pain in the ass before. It will also combine BG1, BG2 and ToB into one seamless experience, all rendered in the BG2 engine. It is perhaps the longest game I have ever played by doing this.

If you have never played through it before, I recommend doing it without the mods, just the recommended fix packs. Instructions are in the download.

Edit: I didn't expect this to get much attention.

If you want it to work smoothly and bug free, install as few mods as possible. The program tells you which mods have the best compatibility and which are recommended. Just follow the instructions carefully and it does a pretty good job.

For a mostly vanilla experience, just go through and check the fixpacks and some of the recommended stuff.

If I went to war with a city like that, I wouldn't care about taking it. Just pillage the tiles outside the mountain and the city becomes useless and would be extremely easy to blockade so it couldn't provide reinforcements anywhere. Plus, you would lose those luxury resources with no hope of getting them back.

You say most defensible, I say most easy to cripple. Against the AI, you're laughing though.

Antibiotics won't directly lower the effectiveness of oral contraceptives (rifampin and some other TB drugs are an exception), but if the antibiotics, or illness itself, cause a person severe diarrhea, that will reduce their effectiveness enough that ovulation could occur.

Not only that, people's adherence to birth control while sick probably suffers as well.

Everyone is remembering these raids with rose-coloured goggles. Yes, the end result and accomplishment was a good feeling.

But did you really enjoy waiting around for an hour to get everyone ready, begin attempt #45 on boss, die in 3 minutes because some rogue decided putting up the highest DPS numbers and pulling the boss to the healers was good strategy, then waiting around for another hour?

Did you really enjoy the constant loot drama? Or just the drama in general?

Did you enjoy that you basically had to book a raid time on a Friday night for 8 hours, and felt obligated to do it instead of going out with your friends?

I did all that for too long. When I look back, I too remember the amazing victories and accomplishment.
The reality was the journey was dull, frustrating and time consuming, but the destination was amazing. Was it worth it? Not for me.

Ah this guy! He loves promoting natural stuff in a sensationalist way. Lots of natural products do have potential and evidence to help in some cases, but he'll turn evidence like, "Raspberry Ketones might help burn extra calories in animal models" to " Raspberry ketones will melt fat, cure diabetes, restore baldness and your sex life!" And people eat it up...drives me crazy.